key: cord-0941119-ekr33f3j
authors: Hanidziar, Dusan
title: Use of anaesthesia machines for mechanical ventilation and sedation in patients with COVID-19 ARDS
date: 2021-05-10
journal: Br J Anaesth
DOI: 10.1016/j.bja.2021.05.002
sha: 3e8f3a8e0732774ce00e662458eeb47a16524b5e
doc_id: 941119
cord_uid: ekr33f3j

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physicians and nurse anaesthetists assumed responsibilities for machine and breathing circuit maintenance. This included performance of machine check every 72 h, heat and moisture exchanger/high-efficiency particulate air filter and breathing circuit exchange at least every 24 h, and changes of water traps and CO 2 absorbers as needed.

Challenges with management of patient-ventilator asynchrony, auto-PEEP, increases in airway pressures, and associated episodes of haemodynamic instability were reported in this same cohort and required continuous vigilance of anaesthesia-trained providers (3) . However, the frequency of these ventilator events was not quantified. In-hospital mortality was 22.9%.

Gouel-Cheron and colleagues(1) reported similar challenges with maintaining anaesthesia machines and breathing circuits, finding that median frequency of filter changes was once daily. A switch from anaesthesia ventilator to ICU ventilator appeared clinically necessary in at least two patients. Mortality in their cohort was 24%.

While neither of the studies evaluated the impact of anaesthesia machine on lung mechanics and patient outcomes, both studies concluded that prolonged ventilation with anaesthesia machines in patients with ARDS was feasible. Although this approach may expand hospital ventilator capacity during a surge of critically ill COVID-19 patients, the demands on the anaesthesia-trained personnel to perform ventilator disconnections and immediately respond to anaesthesia machine alarms may preclude broader use in overwhelmed healthcare systems.

Effectiveness of anaesthesia ventilator use for mechanical ventilation in critically ill patients during the COVID-19 pandemic

Standard Sedation and Sedation With Isoflurane in Mechanically Ventilated Patients With Coronavirus Disease

Rapid establishment of an ICU using anesthesia ventilators during COVID-19 pandemic: lessons learned

The author declares no conflict of interest.